DESCRIPTION: State the application's broad, long-term objectives and specific aims, making reference to the health relatedness of the project. Describe concisely the research design and methods for achieving these goals. Avoidsummaries of past accomplishments and the use of the first person. This abstract is meant to serve as a succinct and accurate description of the proposed work when separated from the application. If the application is funded, this description, as is, will become public information. Therefore, do not include proprietary/confidential information. DO NOT EXCEED THE SPACE PROVIDED. Malaria claims nearly 3 million lives per year, 90% of whom are children under the age of 5 years living in sub-Saharan Africa. In the West African nation of Mali, malaria is indeed the lead killer disease. Nationwide, infant mortality rate is estimated to be 149 per thousand live births while the mortality rate for neonates (age 0-28 days) is estimated to 50 per thousand live births. At the Pediatric ward of the National Teaching Hospital Hopital Gabriel Toure, which is the only tertiary pediatric reference hospital of the country, neonatal mortality was 30%, 36.7% and 61% in 1997, 1999 and 2000, respectively (Sylla M, unpublished data). Because of scarce resources, no exact etiology of these deaths is known. However, based on clinical signs, the great majority of these illnesses are categorized as of infectious origin. Pediatricians use their clinical judgement to prescribe antibiotics and other treatments without laboratory evidence of etiology. Because infants are believed to be protected from malaria, no malaria investigation is performed and no malaria treatment is routinely provided to sick infants and neonates. Since malaria is holoendemic and highly prevalent in the country, we hypothesize that some of the infections in preterm babies and neonates are due to malaria. The specific aim of this proposal is to test the hypothesis that congenital or acquired malaria is responsible for pre-term and neonatal infant mortality at a pediatric reference hospital in Mali. We propose to use sensitive molecular biology and biochemical methods to measure the prevalence of malaria in preterm infants and in neonates admitted to the Pediatric ward of Hopital Gabriel Toure. This proposal is expected to challenge the current belief that malaria is not involved in preterm and neonatal morbidity and mortality in malaria endemic countries. It is likely to lead to a change in the clinical management of pre-term and neonatal infections. In addition, results from this study will be used as preliminary data for further investigations of clinical features and pathogenesis of malaria in preterm and neonatal infants. PERFORMANCE SITE(S) (organization, city, state) Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Bamako, Mali Unit of Neo-natology and Reanimation, Department of Pediatrics, Hopital Gabriel Toure, Bamako, Mali KEY PERSONNEL. See instructions. Use continuation pages as needed to provide the required information in the format shown below. Start with Principal Investigator. List all other key personnel in alphabetical order, last name first. Name Organization Role on Project Abdoulaye Djimde MRTC/ U. Bamako Principal Investigator Mariam Sylla Hopital Gabriel Toure, Bamako Co-Principal Investigator Ogobara Doumbo MRTC/ U. Bamako Mentor/Senior Investigator Mamadou M. Keita Hopital Gabriel Toure, Bamako Mentor/Senior Investigator Belco Poudiougo MRTC/ U. Bamako Investigator Mamadou Tekete MRTC/ U. Bamako Investigator Issaka Sagara MRTC/ U. Bamako Investigator Traore Fatoumata Dicko Hopital Gabriel Toure Investigator Boubacar Togo Hopital Gabriel Toure Investigator Disclosure Permission Statement Applicable toSBIR/STTR Only. See instructions, fj Yes [U No PHS 398 (Rev. 05/01) Page 2 Number pages consecutively atthe bottom throughout Form Page 2 the application. Do not use suffixes such as 2a, 2b. Principal Investigator/Program Director (Last, First, Middle): Djimde AbdOUlaye The name of the principal investigator/program director must be provided at the top of each printed page and each continuation page. RESEARCH GRANT